Impact of Environment on lifelong health Flashcards
What is the Developmental Origins of Health and Disease (DOHaD) is and what does it means?
whether/how early life exposures can determine the health status of an individual later in life, if they can then can we prevent them by managing health early in life?
What challenges may the foetus face that could impact health later on in life?
Fetal infection in utero
Maternal nutrition
Maternal illness
Maternal stress
Maternal medication
Environmental factors/exposures
What are the influences that could possibly affect Long term health and risk of disease?
Biological influences (‘Nature’)
Genetics
Epigenetics
Social and Environmental cues (‘Nurture’)
Environment
Family, Neighbourhood, School
Nutrition (maternal and fetal/child)
Social - behaviours seen – substance use, care giver behaviour (see Still Face Experiment on Insendi)
Health Provisions
What did the Barker Hypothesis conclude?
On average, adults who had a coronary event had been small at birth and thin at two years of age
Thereafter put on weight rapidly.
The risk of coronary events was more strongly related to the rate of change of childhood BMI, rather than to the BMI attained at any particular age of childhood.
What did the Barker hypothesis show?
undernutrition in utero - over nutrition as a child
Increased risk of metabolic syndrome - increased risk of cardiovascular events
What are the mechanisms of DOHaD?
Idea of PROGRAMMING in utero
Leads to epigenetic changes which influence development and physiology
Epigenetics: heritable changes in marks on the DNA that do not change the nucleotide sequence but influence how genes are expressed (where, when and how much a gene is switched on or off)
What are the associations between early environmental exposures and disease?
Associations between early environmental exposures and:
Cardio-vascular disease Type 2 diabetes Lung disease Cancer risk Neurological, special sense and intellectual development Allergic and auto-immune diseases
What are the aims of the NHS Healthy Child programme?
Aims to prevent disease and promote good health
universal
reduce health inequalities
What are the main points brought up in the NHS Healthy Child programme?
Health Promotion (Obesity prevention is a key aspect) Supporting care giving and care givers Screening Immunisation Identification of high-risk families/ individuals for additional support Signposting accident prevention dental hygiene
What are the fundamentals of a good screening test?
The Disease it is screening for
should be able to identified early/before critical point
treatable
prevent/reduce morbidity/mortality
Acceptable/easy to administer
Cost effective
Reproducible and accurate results
What are some examples of important early childhood screening?
Examples of Important Early Childhood Screening:
Newborn Check
Newborn Hearing Screen
Blood spot check
What is Sure Start?
High level of investment in children’s community centres
Aims to help support families with under 5 year old children in low income households
Parent & child education
Health promotion
